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David Baxter PhD

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Quitting Smoking: Different Solutions for Different People
By Holly VanScoy, HealthDay

SUNDAY, Sept. 19 (HealthDay News) -- In the never-ending quest to help Americans stop smoking, experts are honing in on customized programs for groups of people with common problems or similar lifestyles.

"Tobacco cessation is no longer a one-size-fits-all approach," says Paul M. Cinciripini, a professor at the University of Texas' M.D. Anderson Cancer Center in Houston. "We now know various groups have specific concerns and may be motivated to respond by different tobacco cessation programs and treatments."

Cinciripini gives examples of groups as diverse as pregnant women, teenagers, Spanish-speaking individuals and college students, all of which are targeted for different programs by the cancer center.

For example, Project SUCCESS includes offering health information about an individual's respiratory symptoms, lung function and carbon monoxide level to help college students quit smoking. Currently under way at the University of Houston, the project uses nicotine-replacement therapy along with both face-to-face and Internet-based counseling sessions to help students break their tobacco addiction.

Project ASPIRE, by contrast, is aimed at urban, minority high school students and uses much more state-of-the-art technology, primarily because its subjects aren't always as readily available for counseling as college students, researchers say. ASPIRE's material is available as a computer-based interactive, multimedia as well as a Web-based CD-ROM.

Women who quit smoking during pregnancy but take it up again after the birth of their child present a special challenge. Smoking relapse rates for postpartum women are high, with about 80 percent of women resuming smoking by the time their babies reach their first birthday. The treatment for this group involves a lot of telephone-based counseling that allows back-and-forth discussions about issues such as mood changes, stress, support by friends and family and weight concerns. It focuses principally on strengthening a woman's motivation to remain a nonsmoker not only for her own health, but also for the health of the baby.

Another M.D. Anderson smoking cessation program, Adios al Fumar, is directed toward the Spanish-speaking population. Its objective is to increase the reach and effectiveness of smoking cessation services offered in Spanish by the National Cancer Institute's Cancer Information Service (1-800-4-CANCER).

Adios al Fumar has two principal approaches. The first uses a wide range of media sources, including print and broadcast advertising in Spanish-language media outlets and targeted direct mail, to reach Hispanics who smoke; the second uses follow-up individualized telephone counseling.

M.D. Anderson isn't the only medical facility pursuing specialized programming aimed at stopping smoking. There are hundreds of them.

For example, pediatricians at Children's Hospital of Pittsburgh recently rolled out a program called Clean Air Plus for smoking parents of very young children. In addition to helping the adults achieve improved health by avoiding tobacco products, the program motivates them by emphasizing the benefits of protecting their children from secondhand smoke, which is linked to a wide range of health problems in youngsters, including ear and respiratory infections.

One of the advantages of the Clear Air Plus program is that most parents see their child's pediatrician much more often than they see their own internist or family doctor. In fact, pediatricians typically see an infant seven times in the first year of life, and 20 times by the time a child is 5. That gives doctors many opportunities to offer a parent assistance in quitting smoking.

While it's obvious there isn't a single "stop smoking" formula that works for everyone, Edwin B. Fisher, a professor of psychology at Washington University in St. Louis and director of the division for health behavior research at the university's School of Medicine, offers the following advice:
  • Set a clear "quit date" that makes sense for you personally, such as a birthday or some other personal milestone. Choose a Monday morning if you smoke most on the weekends, or a Friday afternoon if you're tempted most at the office.
  • Anticipate the situations in which you're going to be tempted to relapse, and have a realistic plan -- not a wish and a prayer -- for how you're going to cope with those temptations.
  • Consider using a nicotine-replacement device, like gum, a patch, lozenge, inhaler, nasal spray or other medications, for smoking cessation as a way of helping you get used to life without your favorite tobacco product before you have to give it up altogether.
  • Recruit the help of other people. No one else can do it for you, but the cooperation and encouragement of those around you can really help you get a hard job done much better.
More information
The University of Michigan Health System has a fact sheet with additional information about smoking cessation.
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